HomeMy WebLinkAbout5303 Cornerstone Dr - Applications/Basement Finish - 03/10/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER -�/ ' GV V — 6 `-jc/ APPLICATION DATE 3 /01y"
Job Site Address 5,� 103
Unit #
PROPERTY
�OWNER INFO: (All owner information is required - it its not optional) Phone # 7 20 -'3 7 7 "(9C 5.1
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Last name [ , L---,` M First Name Lh /`/ P. Middle
Street Address 0-3 �A jgyt ,C City�l <<efll `S State_Zip �C-):s
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address
Contractor Phone #
City of Fort Collins License #.
City
LEGAL INFO:
Subdivision/PUD � Filing #
Supervisor Cert #
State Zip
Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) r� 9 Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
15' Floor Sq Ft
2nd Floor Sq Ft
Finished Bsmt Sq Ft 0 # of Bedrooms
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft Unfiished Bsmt Sq Ft 4 Z4
# of Full Baths 9 % Baths _AL'�__ 1/2Baths I # of Fireplaces
Air Conditioning: & No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Y,]e�Dor No Temp. Pedestal Yes or No
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (' ❑Residential only) 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $'25= �,osS
Description of Work: a!6p 1�4 — /��a (J p� fi Lei
ktV
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby acknowledg hat I have read this placation and state that the above information is correct and agree to comply with all requirements
contained herein and City o F lins di es d state ws regulating building consttruction// // / / ' �`{�/
Applicant Signature Print Name LL1 L64) yy f� T//`Phon� �� � 7 —
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater O l�g
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE